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Individual

DIANE GUADARA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
835 MAIN ST, HACKENSACK, NJ 07601
(201) 488-8599
(201) 488-4953
Mailing address
835 MAIN ST, HACKENSACK, NJ 07601
(201) 488-8599
(201) 488-4953

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
MD2455
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7695101
NJ
Enumeration date
03/29/2006
Last updated
07/30/2010
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